Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,703.88 / $5,232.50 / $11,627.00	Facility		$1,703.88	$5,232.50	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,703.88 / $1,733.93 / $3,322.57	Professional		$1,703.88	$1,733.93	$3,322.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $5,945.00 / $29,406.00	Facility		$1,895.00	$5,945.00	$29,406.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.72 / $1,673.36 / $2,751.78	Professional		$1,258.72	$1,673.36	$2,751.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,488.06 / $1,488.06 / $2,166.81	Facility		$1,488.06	$1,488.06	$2,166.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,358.48 / $1,604.77 / $1,604.77	Professional		$1,358.48	$1,604.77	$1,604.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,367.10 / $2,042.43 / $3,101.11	Professional		$1,367.10	$2,042.43	$3,101.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,527.94 / $2,186.75 / $2,966.60	Professional		$1,527.94	$2,186.75	$2,966.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.32 / $1,310.45 / $2,005.35	Professional		$116.32	$1,310.45	$2,005.35
United Facility/Professional Facility Modifier Low / Median / High Price $1,771.00 / $3,098.00 / $6,792.00	Facility		$1,771.00	$3,098.00	$6,792.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,527.93 / $2,025.60 / $3,263.34	Professional		$1,527.93	$2,025.60	$3,263.34